Oka Makoto, Suzuki Akinobu, Terai Hidetomi, Kato Minori, Toyoda Hiromitsu, Takahashi Shinji, Tamai Koji, Nakamura Hiroaki
Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka Metropolitan University Osaka, Osaka 545-8585, Japan.
J Clin Med. 2023 Jun 26;12(13):4292. doi: 10.3390/jcm12134292.
In cases of suspected spinal tumors on imaging studies, a biopsy is often necessary for establishing the diagnosis. Predictive factors for tumors or malignancies may help in scheduling biopsies or avoiding unnecessary ones. However, there have been few studies on determining these factors. We aimed to determine the factors associated with the final diagnosis in cases requiring spinal biopsy. This study included 117 patients who underwent image-guided (fluoroscopy- or computed tomography [CT]-guided) needle biopsy of the spine. Data on patient demographic, pathological diagnoses, and final diagnoses were retrospectively collected from the medical records. The imaging features and location of lesions were also evaluated on CT and magnetic resonance imaging. Furthermore, factors related to tumors or malignancies were analyzed. The diagnostic accuracy of biopsy was 94.0%, and there was no difference in the diagnostic accuracy between the fluoroscopic and CT-guided biopsies. Sixty-six and fifty-six patients were diagnosed with spinal tumors and malignant tumors, respectively. Multivariate analysis revealed that a history of malignant tumors and the presence of pedicle lesions and/or extravertebral lesions were related factors for both tumors or malignancy in the final diagnosis. These findings can help determine the necessity for or timing of biopsy in patients with suspected spinal tumors.
在影像学检查怀疑有脊柱肿瘤的病例中，活检对于确诊往往是必要的。肿瘤或恶性肿瘤的预测因素可能有助于安排活检或避免不必要的活检。然而，关于确定这些因素的研究很少。我们旨在确定在需要进行脊柱活检的病例中与最终诊断相关的因素。本研究纳入了117例行影像引导（透视或计算机断层扫描[CT]引导）脊柱穿刺活检的患者。从病历中回顾性收集患者人口统计学、病理诊断和最终诊断的数据。还在CT和磁共振成像上评估病变的影像学特征和位置。此外，分析与肿瘤或恶性肿瘤相关的因素。活检的诊断准确率为94.0%，透视引导和CT引导活检的诊断准确率无差异。分别有66例和56例患者被诊断为脊柱肿瘤和恶性肿瘤。多因素分析显示，恶性肿瘤病史以及椎弓根病变和/或椎体外病变的存在是最终诊断中肿瘤或恶性肿瘤的相关因素。这些发现有助于确定疑似脊柱肿瘤患者活检的必要性或时机。
